Pacific Sports And Spine

LBN: Pacific Sports And Interventional Spine, Llc
Pacific Sports And Spine is an health care organization with primary practice located at 217 Division Ave , Eugene OR 97404-5429. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is the primary health care specialty. Pacific Sports And Interventional Spine, Llc can be contacted via phone (541) 686-3791, or through Rea, Leslie via phone (541) 743-9003.

Contact Information

Primary practice address
217 Division Ave Eugene OR 97404-5429
Phone: (541) 686-3791
Fax: (541) 686-3795
Website:
Map and Directions
Authorized official contact:
Name: Rea, Leslie
Phone: (541) 743-9003

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X MD27887 Oregon
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X MD28629 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00800 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00420 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA152998 Oregon

Profile Details

NPI number 1881186336
LBN Legal business name Pacific Sports And Interventional Spine, Llc
DBA Doing business as Pacific Sports And Spine
Authorized official Rea, Leslie
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2018
Last updated Nov 6th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881186336 NPPES
Oregon MEDICAID 500632183
Oregon MEDICAID 244117
Oregon MEDICAID 500604467
Oregon MEDICAID 500608609
Oregon MEDICAID 500624453

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